Monitoring indicators

Agid and the Ministry of Health, in agreement with the regions’ administrations, established a series of indicator to check the progress and the implementation of the Electronic Health Record (EHR) on national territory. 

The monitoring activities are divided in two distinct series: Implementation and Usage

Implementation indicators

Implementation indicators’ aim is to check the progress of regional realization of the Electronic Health Record. The indicator is given by the average of each service provided for in the plan.

Below are listed:
 

• Enabling components: state of implementation for the personal data register of the citizens, workers and healthcare companies. State of implementation of the network infrastructure;
• Citizens’ access services: state of implementation of the citizens’ authentication system, collection arrangement and consent management. State of implementation of the Electronic Health Record access mode (website, citizens’ services desk). Implementation of the citizens’ personal health record;
• GP/PLS’ (general practitioner/ pediatrician) access services: state of implementation of the methods GP/PLS use to access EHR and state of implementation for access and uploading authorization for the GP/PLS;
• Healthcare facilities’ access services:  state of implementation of the methods healthcare facilities use to access EHR and access and uploading authorization for the health workers;
• EHR interoperability services: state of implementation of the interregional interoperability services;
• Medical records management services: state of implementation of the management and digitalization of medical records provided by healthcare facilities (health professionals training, catalogues mapping, etc.);
• Patient summary management services: state of implementation of the management and digitalization of Patient summaries by the GP/PLS (medical training, software applications, etc.).

Usage indicators

The Usage monitoring indicators aims to track the circulation on national territory of the Electronic Health Record (EHR) and its concrete usage by citizens, doctors and healthcare facilities.

Below are the aspects that the Usage indicators highlight:
 

• Citizens: the number of citizens assisted (Italian regions residents who choose an GP/PLS) that gave consent for the EHR data uploading, compared to the number of regions’ citizens assisted.  The number of citizens assisted that have accessed the EHR at least once compared to the number of citizens assisted with at least one medical record available in the last 90 days;
• Doctors: the number of GP/PLS that have been using the EHR compared to the total number of service enabled GP/PLS. The number of Patient Summaries drawn up by GP/PLS compared to the total number of the activated EHR;
• Healthcare facilities: the number of EHR enabled health professionals compared to the total number of the healthcare facility’s workers. The number of digitized medical records in the EHR compared to the total number of medical records provided by the healthcare facility. In the launch phase only lab medical records are monitored.

The Usage indicator includes data from each public structure on the territory (ASL, AO, IRCSS, Public Foundations). In the regional section a graphic shows the sum of the values.

Monitoring Dashboard

The monitoring dashboard available in the home page highlights and summarizes the numbers of the Electronic Health Record:

• the number of active Regions, i.e. regions in which there is at least one activated EHR;
• the number of subsidiarity Regions, i.e. regions that have their EHR services partially or 100% active at the INI (National Interoperability Infrastructure);
• The number of structured and digitized laboratory reports produced by national public health structures;
• The number of EHR activated on a national basis.

The findings are made on a quarterly basis by the regions through the restricted access on the portal. Data are entered in the system on the month following the reference quarter. At the end of the month data are published in the Monitoring section of the portal and in the home page.

For further information, please refer to the annex B “EHR implementation monitoring” in the “Guidelines for the launch of regional project plans for the implementation of the Electronic Health Record” published by Agid and the Ministry of Health on March 31st, 2014.